Recurrence of H pylori after several eradication therapies

Posteradication H pylori recurrence is higher during the first year, is more frequent in younger patients and in those treated with low efficacy therapies, reports the latest issue of Alimentary Pharmacology & Therapeutics.

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Dr Gisbert and colleagues from Spain studied the incidence of Helicobacter pylori recurrence.

The research team evaluated its chronological aspects, and the variables that might influence it.

The team prospectively studied patients in whom H pylori had been eradicated.

Therapies were classified as low and high efficacy regimens.

The team performed 13C-urea-breath-test 4 to 6 weeks after completion of therapy, and it was repeated yearly up to 5 years.

In some patients, endoscopy with biopsies was also performed to confirm H pylori eradication.

A total of 1000 patients were included, giving 2744 patient-years of follow-up.

The probability of being H pylori-negative at 5 years was 91%

Alimentary Pharmacology & Therapeutics

The researchers observed 71 H pylori recurrences.

The team found that the probability of being H pylori-negative at 1 year was 95%, and at 5 years 91%.

In the multivariate analysis, low age and low efficacy therapies correlated with 1-year H pylori recurrence.

Differences were observed when Kaplan-Meier curves were compared depending on age and therapy regimen.

Dr Gisbert's team concludes, “Risk of posteradication H pylori recurrence is higher during the first year, which suggests that most recurrences during this period are recrudescence and not true reinfections.”

“H pylori recurrence is more frequent in younger patients and in those treated with low efficacy therapies.”

“However, it is exceptional if high efficacy therapies are used, in which case post-therapy eradication can be safely confirmed at 4 weeks with 13C-urea-breath-test.”